Myelodysplasia syndromes (MDS) are a heterogenous group of clonal stem cell disorders which generally occur in adults. MDS are rare seen in patients with end-stage renal disease (ESRD). In this study, we presents a 38-year-old woman with ESRD who had regularly received hemodialysis therapy for two years. In this patient, we observed pancytopenia and the patient who survived for nine months by supportive therapy. In conclusion, supportive therapy should be prefered in MDS' patients with ESRD.